Provider Demographics
NPI:1407953474
Name:HELOU, KHOLUD NOOR (MFT, PSYD)
Entity Type:Individual
Prefix:
First Name:KHOLUD
Middle Name:NOOR
Last Name:HELOU
Suffix:
Gender:F
Credentials:MFT, PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 W ARROW HWY
Mailing Address - Street 2:STE 204
Mailing Address - City:SAN DIMAS
Mailing Address - State:CA
Mailing Address - Zip Code:91773-2338
Mailing Address - Country:US
Mailing Address - Phone:909-482-4444
Mailing Address - Fax:
Practice Address - Street 1:1305 W ARROW HWY
Practice Address - Street 2:STE 204
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-2338
Practice Address - Country:US
Practice Address - Phone:909-482-4444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2019-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38277106H00000X
CAPSY23698103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist